Perinatal mortality and morbidity in breech presentation

Area of Science:

• Obstetrics
• Perinatology
• Neonatal Mortality

Background:

• Breech presentation is associated with higher perinatal mortality rates compared to cephalic presentations.
• The Royal Women's Hospital, Melbourne, observed a 10.4% perinatal mortality for breech presentations between 1974-1976.

Purpose of the Study:

• To analyze perinatal mortality rates in breech presentations.
• To evaluate the impact of infant weight on mortality in breech presentations.
• To assess the potential benefits of cesarean section for breech presentation.

Main Methods:

• Retrospective analysis of perinatal deaths in breech presentation cases.
• Categorization of infant deaths based on birth weight (≥2500g and 1000-2499g).
• Identification of causes of death, including congenital abnormalities, prematurity, hypoxia, and birth trauma.

Main Results:

• Overall perinatal mortality for breech presentation was 10.4%, five times the hospital average.
• For infants ≥2500g, mortality was 1.8%, with most deaths due to pre-existing conditions.
• For infants 1000-2499g, mortality was 33.9%, with prematurity, hypoxia, and birth trauma as major contributors.

Conclusions:

• Elective cesarean section is not justified for term breech infants (≥2500g).
• Cesarean section may reduce perinatal loss in premature breech infants (<2500g).
• Reducing intrauterine hypoxia and birth trauma through cesarean section could improve outcomes for premature breech infants.